The Impact of TouchRobert Brooks, Ph.D.

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I recently read an article that appeared in The New York Times titled “Evidence that Little Touches Do Mean So Much.” The article, written by Benedict Carey, noted that in recent years psychologists have turned increasing attention to studying physical contact as a powerful form of communication. Carey writes, “Momentary touches, psychologists say- whether an exuberant high five, a warm hand on the shoulder, or a creepy touch to the arm- can communicate an even wider range of emotion than gestures or expressions, and sometimes do so more quickly and accurately than words.”

Carey continues, “The evidence that such messages can lead to clear, almost immediate changes in how people think and behave is accumulating fast. Students who received a supportive touch on the back or arm from a teacher were nearly twice as likely to volunteer in class than those who did not, studies have found. A sympathetic touch from a doctor leaves people with the impression that the visit lasted twice as long, compared with estimates from people who were untouched.”

In analyzing this research one might raise a question rooted in the chicken and the egg dilemma. Are teachers or doctors more likely to touch students or patients who initially display more cooperative behaviors or is touch a catalyst in eliciting these behaviors? For instance, there are some children and adults who are not comfortable being touched whether as a result of tactile hypersensitivities, or attachment problems, or having been abused. Would teachers or doctors immediately sense their discomfort with touch and refrain from doing so? If that were the case, would a lack of touch in the relationship compromise participation in class or arouse the feeling that the doctor did not care about them? Important questions for further study.

I believe that for the large majority of children a hand placed gently on their arm or shoulder would be interpreted as a sign of caring, with the emphasis on the word gently. If a child tenses up when touched on the shoulder, it is a sign for the adults that they must move slowly as they engage that child physically. Many of my child patients who at first were not comfortable with physical contact eventually seemed to welcome it as our relationship progressed, whether touch was in the form of a handshake or sitting close together playing a board game or handing material to each other as we built something. An illustration of a therapeutic breakthrough involving touch occurred with a boy who was my patient who was reluctant to accept or engage in any kind of physical contact. One day we took a walk on the grounds of a psychiatric hospital at which I worked. He surprisingly requested that I lift him so that he could sit on the branch of a tree and then requested that I hold his arm so that he did not fall. After that moment, he initiated many more opportunities to be touched and a more trusting relationship blossomed.

Since I am a big sports fan, I was especially fascinated by Carey’s article when he described research conducted by Dr. Michael Kraus and several colleagues at the University of California, Berkeley. They were interested in whether supportive touch is related to performance and decided to examine that question by “analyzing interactions in one of the most physically expressive arenas on earth: professional basketball.” I was impressed by the minute detail of the research. Kraus and his associates “coded every bump, hug, and high five in a single game played by each team in the National Basketball Association early last season. They report that with few exceptions, good teams tended to be touchier than bad ones. The most touch-bonded teams were the Boston Celtics and the Los Angeles Lakers.” These two teams eventually met in the NBA finals.

It was also observed that the touchiest player was Kevin Garnett of the Celtics. “Within 600 milliseconds of shooting a free throw, Garnett has reached out and touched four guys,” noted one of the researchers. To address once again the chicken or the egg controversy, Carey notes, “To correct for the possibility that the better teams touch more often simply because they are winning, the researchers rated performance based not on points or victories but on a sophisticated measure of how efficiently players and teams managed the ball- their ratio of assists to giveaways, for example. And even after the high expectations surrounding the more talented teams were taken into account, the correlation persisted. Players who made contact with teammates more consistently and longest tended to rate highest on measures of performance, and the teams with those players seemed to get the most out of their talent.”

Kraus cautioned that the study did not prove that touch caused the better performance, asserting, “We still have to test this in a controlled lab environment.”

Carey offers a possible reason for these findings based on brain research. “If a high five or an equivalent can in fact enhance performance, on the field or in the office, that may be because it reduces stress. A warm touch seems to set off the release of oxytocin, a hormone that helps create a sensation of trust, and to reduce levels of stress hormone cortisol. In the brain, prefrontal areas, which help regulate emotion, can relax, freeing them for another of their primary purposes: problem solving. In effect, the body interprets a supportive touch as ‘I’ll share the load.'”

I don’t know if I’ll ever be able to watch another Celtics game in the same way I have in the past, especially when Kevin Garnett takes a foul shot.

I believe that all of us are aware of how important touch is and that we must find ways of expressing physical contact that is comfortable for us, the children in our lives, and others. In reading Carey’s article I immediately thought of parents I saw in counseling sessions. They had a son on the autism spectrum who displayed tactile hypersensitivity so that he did not welcome his parents putting their hands on his shoulder or giving him a light hug. His rejection of their touch greatly distressed these very warm, demonstrative parents. However, this boy loved baseball and memorized the hitting and pitching statistics of each of the Red Sox players, seemingly a practice that reflected one of the obsessive traits associated with his autistic behavior.

This boy’s father realized that if he were to develop a closer relationship with his son he would have to “join” his son’s interests. It was not difficult to do since this man also loved sports. He took his son to games at Fenway Park and they also watched Red Sox games together on television at home. He discovered that whether at Fenway Park or watching at home, his son, who normally shied away from touch, readily accepted and seemed delighted by high fives. The father tearfully told me, “The high fives might not mean as much to some fathers whose children regularly hug them, but for me it is a sign of connection with my son that I don’t often experience.”

I would be remiss not to mention that research has shown the benefits of touch when we pet cats or dogs- lowered blood pressure, reduced stress, a decreased sense of loneliness, and the reinforcement of a more positive mood.

My Memories of Touch

In addition to reflecting upon my clinical activities, Carey’s article triggered some strong personal memories related to touch from my childhood. In workshops that I offer for teachers and parents I frequently request participants to recall both their most satisfying and least satisfying experiences as children with their teachers or parents. I encourage them to identify what factors rendered these memories positive and negative and then I ask if they use these memories to guide what they do with their students or their own children today. Not surprisingly, while the specific examples may vary considerably from one person to the next, there are common themes that emerge.

Dominant positive themes include being asked to help others, a special time alone with a significant adult, and expressions of acceptance and unconditional love directed towards the child. Negative themes invariably involve being subjected to rejection, humiliation, or intimidation. A majority of these childhood memories remain vivid and filled with emotion regardless of how long ago the situation took place. When men and women 60 or 70 years of age share their childhood experiences at my workshops, many do so with palpable emotion. The smiles, laughs, tears, and anger associated with these memories belie the fact that the experiences they are reporting occurred 40 or more years in the past. It is little wonder that the title for an article I authored about one’s memories of school included the words “Indelible Memories of School.” The same is true of memories of one’s parents. Many of these memories do not fade but continue to influence our lives decades after the event transpired.

The message I attempt to convey is that just as we carry around positive and negative memories of the influential adults in our childhood, the children in our lives will be filled with memories of us. I ask, “What would you like these memories to be?” “Are you interacting in ways with children so that their memories will be in accord with your goals and wishes?”

Prior to asking others to engage in exercises such as recalling positive and negative memories from one’s childhood, I have found it helpful to first consider how I would answer the questions. I do so for a couple of reasons. One is to assess the relevance of the exercise by examining the strength of the emotions that are elicited within me. Second is to compare my experiences with others.

My sixth grade teacher. I know that I am fortunate that almost all memories involving my parents are positive. So too are the vast majority of experiences with my teachers, with a few notable exceptions. One memory of school, which I have highlighted in several of my workshops, occurred with my sixth grade teacher, Mr. Jerry Mannato. My fifth grade teacher was harsh and demeaning, quick to put down students including myself. I believe it was the worst year I ever had in school. When describing the impact of my fifth grade experience, I say with some humor, “If New York City did not have a law about dropping out of school when you are 10 or 11 years old, I would have considered it.”

Based on what my fifth grade experience, I began sixth grade with some trepidation. However, through the grapevine I heard that my new teacher was demanding and expected a lot from his students but that he really liked kids. I remember thinking, “I don’t mind how demanding he is. The important thing is that he likes kids! That will be a welcome change from this past year.” Little did I know what was to occur during the first week of school with Mr. Mannato, a brief magical moment that has lasted a lifetime. He was to become for me what the late psychologist Julius Segal called a “charismatic adult,” an “adult from whom a child gathers strength.”

Mr. Mannato loved art and creativity and encouraged the same love in his students. One of my “islands of competence” during that time was drawing, especially cartoons. On the second or third day of class Mr. Mannato asked each of us to draw whatever we would like. At first I drew an abstract design and then proceeded to draw some cartoon figures. Mr. Mannato walked around the class surveying each student’s drawings. He approached my desk and I suddenly felt a hand on my shoulder. I looked up and he said, “Bobby, you have some real artistic ability. It’s great to see. We’ll have to display some of your artwork this year.” While I loved his words, what I vividly remember with great fondness was the hand on my shoulder- a gesture that I interpreted as a sign of encouragement, support, and caring. As I look back on that moment, I recognize as Carey reported in his article, the power of touch to convey strong feelings.

I am very aware that many students and teachers will not have the same experience as occurred in my sixth-grade classroom. If anything, when I recount the story of Mr. Mannato’s actions, many current teachers of both young children and adolescents voice regret that especially in light of the sexual abuse epidemic, they are warned against touching students. I certainly understand the roots of this proscription against physical contact. I have also come to accept at least to some extent that the rule has to be rigidly applied so that there are no gray areas of teacher behavior that might invite controversy. In addition, I appreciate that Mr. Mannato’s ease in placing his hand on my shoulder probably would not have been as acceptable if he did the same thing with a girl in the class. Yet, I believe that given the benefits of touch in enriching a relationship, consideration should be given to having an ongoing dialogue about the pros and cons of touch between teacher and student or therapist and student. When, if ever, is it appropriate and, if it is appropriate, what forms should it take (e.g., handshake, hand on the shoulder)?

As a therapist I am very cognizant of the boundaries involved with touch between therapist and patient. There are clinicians who even caution against a handshake with a patient, although I have rarely found that to be an issue as long as one is aware of cultural and religious issues that pertain to touching. For instance, some religious practices prohibit males or females, unless they are married to each other, from touching even in the form of a handshake. To illustrate the wide spectrum of beliefs, I have also spoken in countries where immediately following my presentation both men and women have given me a hug. As a former training director in psychology I always discussed with trainees in the field of mental health the need to understand and respect the many complex issues involved with touch.

Whatever the prohibitions today, I am pleased that I felt the comforting hand of Mr. Mannato on my shoulder many years ago. He was truly a gifted teacher with clear expectations. His love of his students permeated the classroom, bringing out the best in all of us.

My parents. And, of course, I remember the touch of my parents who were always demonstrative in expressing their love even when I was an adult. One would hope that touch borne of love would not present issues between parent and child as it does between professional and child. However, I know, especially from my clinical practice, that a number of children have rarely, if ever, experienced the loving embrace of a parent. For some, touch is primarily associated with punishment. Years ago I read an article that lamented that in some families touch was dominated by corporal punishment or spanking rather than as an expression of caring and love.

I have countless wonderful memories of my parents. I have frequently noted that I was blessed to grow up in their home. An example of one memory that I think about often involved my father and the sense of security that came from his touch. My father owned a small candy store in Brooklyn. When I was about four years old he took me to one of his distributors to pick up some items that he needed immediately. I was on a platform with the distributor as he handed my father a few boxes of merchandise. I am certain the platform was only a foot or two high, but to a four-year-old, it seemed as if I were on top of a mountain. When the distributor was finished filling the order, he picked me up and said, “And now your father will catch you.” He then tossed me to my father’s waiting arms. I don’t remember being scared at being tossed; what I recall is a feeling of security and love in landing in my father’s arms. He held me tight, smiled, and kissed me. When I myself became a father I hoped that at some point my sons would experience these same kinds of feelings with me.

A Few Final Thoughts

Child clinicians and researchers have long known that holding, cradling, and displaying affection towards a baby were essential ingredients in nurturing a child’s physical, emotional, and brain development. Physical contact is a basic component of the human experience. The impact of an absence of touch has been well-documented in children growing up in orphanages that provided for their basic nutritional needs but not for their needs to be spoken to or held and cuddled.

While there is no doubt that we must strive to understand and respect the boundaries associated with physical contact in a variety of relationships and cultures, hopefully we will not lose opportunities to engage in touch when it is acceptable and will enrich our lives.

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